Unified Physician Management

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Claims Coordinator

at Unified Physician Management

Posted: 12/3/2018
Job Status: Full Time
Job Reference #: 667

Job Description

The Claims Coordinator is responsible for resolving claims issues within the Care Centers.  The position is responsible for A/R denials, underpayments, payments not according to contractual agreements, and any unresolved claims issues that may arise directly from the Care Center.  There is an expectation of consistent communication via telephone and/or email to multiple entities (internally & externally) to resolve these issues. Duties include but are not limited to:

  • Monitor A/R and Collections
  • Communicate with Care Center staff in regards to A/R
  • Follow up on unpaid claims according to standards
  • Determine accuracy of Insurance payments and follow up on discrepancies
  • Review and appeal unpaid and denied claims
  • Identify and bill secondary or tertiary insurances
  • Run and build reports as required
  • Respond to patient and/or insurance companies billing questions 

Skills/ Requirements 

  • High school diploma or equivalent
  • Minimum of 5 years experience interpreting insurance explanation of benefits, plan benefits, and patient benefits/liability
  • Minimum of 5 years experience working with medical claims (HCFA 1500, UB04, UB92), insurance billing, payment posting, insurance collections, appeals, and medical records requirements/requests
  • Must possess excellent customer service skills communicating logically and clearly (verbally and in writing)
  • Experience and knowledge of insurance payer websites (e-appeals & verification of eligibility)
  • Experience with Microsoft Office & proficiency in data entry
  • Knowledge of Insurance guidelines and contracting information according to industry standards
  • Knowledge of Medical Billing & Coding or Certification is a plus
  • Knowledge of governmental insurance especially Medicare and Medicaid according to industry standards